Individual
MINDY TATERA TABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9150 W INDIAN SCHOOL RD, SUITE 118, PHOENIX, AZ 85037-2384
(602) 938-6960
(602) 938-6069
Mailing address
5620 W THUNDERBIRD RD, F1, GLENDALE, AZ 85306-4636
(602) 938-6960
(602) 938-6069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
32919
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
960858001
—
AZ
Enumeration date
08/12/2005
Last updated
09/14/2016
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